2.2 (1 - Australia's health system)

Question 1

What does medicare cover?

Answer 1

• Out-of-hospital expenses (all/some) - consultation fees for doctors/specialists, test + exams needed to treat illness, + most surgical procedures.
• In-hospital expenses - public patient in private hospital medicare will pay 75% of schedule fee.

Question 2

Medicare

Answer 2

Australia’s universal health insurance scheme which gives all Australian citizens access to healthcare that is subsidised by the government.

Question 3

What medicare doesn’t cover?

Answer 3

• Most surgical costs associated with PH.
• Most dental examinations + treatments
• Ambulance services
• Home nursing + treatment
• Allied health services (unless referred to by GP or carried out in public hospital).

Question 4

Medicare advantages

Answer 4

• Choice of doctor for OOH expenses.
• Reciprocal agreement with other countries allowing free healthcare.
• Available to all Aus citizens.

Question 5

Medicare disadvantages

Answer 5

• Often doesn’t cover full amount of doctors visit.
• Does not cover alternative therapies.
• Waiting list for many treatments.

Question 6

Medicare funding

Answer 6

• Medicare levy
• Medicare levy surcharge
• General taxation

Question 7

Medicare levy

Answer 7

Additional 2% placed on taxable income of most taxpayers/those earning more than $20,000 (those with low income may be exempt).

Question 8

Medicare levy surcharge

Answer 8

People earning more than a certain amount p.a ($90,000 or $180,000) have to pay an extra tax, which increases as income increases.
- Encourages high income earners to take out PHI, reduces demand on medicare.

Question 9

Schedule fee

Answer 9

Amount set by fed gov for each medical service.

Question 10

Out-of-pocket expenses

Answer 10

Costs that patient must pay themselves (when doctor charges more than schedule fee).

Question 11

Bulk-billing

Answer 11

When doctor/specialist charges only schedule fee (payment claimed directly from Medicare so no out-of-pocket expenses).

Question 12

Patient co-payments

Answer 12

Payment made by patient for health products + services in addition to amount paid by gov.

Question 13

Allied health services

Answer 13

Health services provided by trained professionals who are not doctors, dentists, or nurses.

Question 14

Pharmaceutical benefits scheme (BPS)

Answer 14

The government provides free medicines to pensioners + 139 lifesaving and disease preventing medications to the rest of the community free of charge.